title: Self-esteem in a clinical sample of morbidly obese children and adolescents.
abstract: OBJECTIVE
  To study self-esteem in clinical sample of obese children and adolescents.
  
  
  METHODS
  Obese children and adolescents aged 8-19 years (n = 107, mean age 13.2 years, mean BMI 32.5 [range 22.3-50.6], mean BMI z-score 3.22 [range 2.19-4.79]; 50 boys and 57 girls) were referred for treatment of primary obesity. Self-esteem was measured with a validated psychological test with five subscales: physical characteristics, talents and skills, psychological well-being, relations with the family and relations with others. A linear mixed effect model used the factors gender and adolescence group, and the continuous covariates: BMI z-scores, and BMI for the parents as fixed effects and subjects as random effects.
  
  
  RESULTS
  Age and gender, but neither the child's BMI z-score nor the BMI of the parents were significant covariates. Self-esteem decreased (p < 0.01) with age on the global scale as well as on the subscales, and was below the normal level in higher ages in both genders. Girls had significantly lower self-esteem on the global scale (p = 0.04) and on the two subscales physical characteristics (p < 0.01) and psychological well-being (p < 0.01).
  
  
  CONCLUSIONS
  Self-esteem is lower in girls and decreases with age. In treatment settings special attention should be paid to adolescent girls.
authors.affiliation: Childhood Obesity Unit, University Hospital Malmö, Malmö, Sweden. paulina.nowicka@skane.se
authors.forename: P
authors.initials: P
authors.lastname: Nowicka
authors.forename: P
authors.initials: P
authors.lastname: Höglund
authors.forename: P
authors.initials: P
authors.lastname: Birgerstam
authors.forename: I
authors.initials: I
authors.lastname: Lissau
authors.forename: A
authors.initials: A
authors.lastname: Pietrobelli
authors.forename: C-E
authors.initials: CE
authors.lastname: Flodmark
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology*; D011594:Psychometrics; D012649:Self Concept; D012647:Self-Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult